Self-reported symptoms and exercise-induced asthma in the elite athlete

RUNDELL, KENNETH W.; IM, JOOHEE; MAYERS, LESTER B.; WILBER, RANDALL L.; SZMEDRA, LEON; SCHMITZ, HEATHER R.

Medicine & Science in Sports & Exercise:
CLINICAL SCIENCES: Clinical Investigations
Abstract

RUNDELL, K. W., J. IM, L. B. MAYERS, R. L. WILBER, L. SZMEDRA, and H. R. SCHMITZ. Self-reported symptoms and exercise-induced asthma in the elite athlete. Med. Sci. Sports Exerc., Vol. 33, No. 2, 2001, pp. 208–213.

Purpose: The purpose of this study was to compare self-reported symptoms for exercise-induced asthma (EIA) to postexercise challenge pulmonary function test results in elite athletes.

Methods: Elite athletes (N = 158; 83 men and 75 women; age: 22 ± 4.4 yr) performed pre- and post-exercise spirometry and were grouped according to postexercise pulmonary function decrements (PFT-positive, PFT-borderline, and PFT-normal for EIA). Before the sport/environment specific exercise challenge, subjects completed an EIA symptoms-specific questionnaire.

Results: Resting FEV1 values were above predicted values (114–121%) and not different between groups. Twenty-six percent of the study population demonstrated >10% postexercise drop in FEV1 and 29% reported two or more symptoms. However, the proportion of PFT-positive and PFT-normal athletes reporting two or more symptoms was not different (39% vs. 41%). Postrace cough was the most reported symptom, reported significantly more frequently for PFT-positive athletes (P < 0.05). Sensitivity/specificity analysis demonstrated a lack of effectiveness of self-reported symptoms to identify PFT-positive or exclude PFT-normal athletes. Postexercise lower limit reference ranges (MN-2SDs) were determined from normal athletes for FEV1, FEF25–75% and PEF to be −7%, −12.5%, and −18%, respectively.

Conclusion: Although questionnaires provide reasonable estimates of EIA prevalence among elite cold-weather athletes, the use of self-reported symptoms for EIA diagnosis in this population will likely yield high frequencies of both false positive and false negative results. Diagnosis should include spirometry using an exercise/environment specific challenge in combination with the athlete’s history of asthma symptoms.

Author Information

Sports Science and Technology Division, United States Olympic Committee, Lake Placid, NY 12946

March 2000

May 2000

© 2001 Lippincott Williams & Wilkins, Inc.